Going for 2nd opinion - need your help

^^
+1 for wanting it OUT!!!!!!!!!!!!!!!!!!

Lori
Pat's advice is the Best! My situation was "aggressive bladder cancer" and within a month I had 2 TURBs and a Full Radical Cystectomy. I am 18 months out and life is normal again! Follow the more aggressive treatment schedule if you have a choice. BCG treatments were never mentioned in my case. I am so glad, now that I have more information, that BCG was never an option. I wanted it OUT!

George

Hi Lori -

RC was recommended with no muscle involvement (scenario 2) do to the quickness my cancer had returned. In 5 weeks from my 2nd TURBT I went from my bladder being cleaned out to being full of cancer again with CIS showing up also. Given my age, my surgeon said my best odds for no recurrence were to do the RC. And I think in scenario 3 the "probable" RC was dependent on how effective the chemo would be, especially if the cancer had moved to the Lymph system and beyond. I think a better term would have been delayed instead of probable. Pat's response is, as usual, right on the money. Glad to hear you've got a top notch doc - you're on the right track! Good luck and keep the questions coming.

Andy

Hi Lori,
You're seeing a top specialist in bladder cancer in Dr. Pruthi..he's seen it all and written about it.
Under articles of Interest on the forum you'll find many papers written on T1G3.....the caveat being if it returns after BCG or Mitomycin C..its pretty aggressive and end results are better with a cystectomy and reconstruction. You absolutely want to make sure you have not been understaged.
T2 is always muscle invasive and cystectomy a given. Whether or not chemo is advised..its individual to the person. If CT/PET scans, bone scans, blood work all clear chemo may be withheld until after cystectomy. It depends on your doctor. I was T2a just into the first muscle and no pre-chemo given. I was totally clean after cystectomy so i did not have to face that protocol. In fact my surgeon who performed my Re-Turb did such a incredible job of getting all of the tumor and margins it had not come back and i actually had a clean bladder with a few marginal displasic cells floating around. It would have come back and i'm happy that i headed it off at the pass.
Make sure you understand all 3 diversions if that may be necessary.
pat

Andy, if there wasn't muscle involvement then why would RC be recommended (scenario #2)? In your 3rd option - muscle involvement - why would RC be probable and not a certainty?

Good Luck to you and I look forward to your thoughts. LORI

Lori,
I, Like Andy was T1G3. My first Uro wanted to go with BCG. I also went to U of M for a second opinion.
They told me that my type of cancer wouldn't even be receptive to BCG.
So I would be asking that. Is your type of cancer receptive to BCG?
The only way they could guarentee life was a RC & Neobladder. I like Andy, really didn't like the idea of the continuing saga of BCG. I had surgery, and within 6 months, for the most part, it was behind me.
A second opinion is the best thing you can do.
Keep the big picture in mind..........LIFE.

We are here for you, Jim